Numerous COVID-19 deaths occur in area ‘care center’

UPDATED: May 5Facility is issued an “Emergency Suspension” of its license; patients to be moved. The exact number is still in flux, but here’s why State regulators have stepped in to manage a large health care center in outer East Portland …

Here at Healthcare at Foster Creek, which borders the Pleasant Valley and Powellhurst-Gilbert neighborhoods and is situated near the Springwater Corridor Trail, officials say several patients have died after coming down with the COVID-19 coronavirus.

Story and photos by David F. Ashton

See the important update to this article at the end of the story.

It’s been in the news: Somewhere between nine and fourteen patients (the official number has fluctuated over time) in the Healthcare at Foster Creek care center, at 6003 SE 136th Avenue, have died after contracting the novel COVID-19 coronavirus in the past few weeks.

With 33 total COVID-19 deaths in all of Multnomah County, even quantity of deaths in one facility due to the coronavirus caught the attention of Oregon Department of Human Services (DHS) Aging and People with Disabilities Safety, Oversight & Quality Unit.

DHS licenses “nursing facilities” in Oregon, and is charged with “surveying” nursing homes and care facilities to assure that at least minimum levels of health care and safety are being met.

Inside this sprawling facility, state health care investigators look into general conditions, staffing, and patient care procedures.

From April 10 through April 12, DHS staff conducted interviews inside Healthcare at Foster Creek, made observations, and reviewed the health care records, commonly called “charts”, of patient

Shortly thereafter, on April 15, DHS issued the facility’s operator – the for-profit “St. Jude Operating Company LLC” (not affiliated with the famous St. Jude Children’s Research Hospital) – a 14-page “Notice & Order Imposing License Conditions, and Right to Request a Hearing” which detailed 22 concerns about staff behavior and conditions.

To see a PDF image of this document, CLICK HERE.

The document then details “the facility’s violation of the following Oregon Administrative Rules” – listing five violations with patient care plans, staffing, failing to note changes of medical conditions, failing to prevent the spread of COVID-19, and failing to appropriately use personal protective equipment to prevent the spread of COVID-19.

On page 6 of the document, the DHS survey team is issuing a “license condition” to continue operating. “In addition, DHS finds that the residents of the facility are in risk of immediate jeopardy.”

-3 DHS officials use the term “immediate jeopardy” when considering the facility’s operating license.

An expert comments
Other local media outlets have presented stories about this facility and the stories of those who have lost loved ones in Healthcare at Foster Creek; but they have only lightly touched on the DHS findings and action required – and more specifically, what it means in plain language.

East Portland News asked a retired, 30+ year owner and operator of high-quality nursing homes and health care facilities within Oregon and other states, to carefully read and comment on the DHS document.

License in ‘immediate jeopardy’
“Without a doubt, ‘immediate jeopardy’ is the most severe licensure condition of operation,” he began. “It consists of, in essence, that patients (and staff, considering COVID-19) are in immediate jeopardy of serious illness or death, and action needs to be taken now.

“Less serious deficiencies (or infractions) generally are given a timeline of 30 days or more, depending on the severity issue,” he told us.

Management consultant called in
Part of the DHS requirement for the facility to keep operating was a requirement to bring in a “temporary management consultant to assist, guide, and make recommendations, regarding the day-to-day operations of the facility”, as the document states.

“I don’t believe I’ve seen this before – for non-financial reasons – but it could have happened,” the expert commented. “State officials rarely actually close down a facility, which in this instance would not be wise, because transferring medically frail patients to another facility typically does more harm than good.

“But, this kind of licensure provision appears to be designed to get the ‘full attention’ of the operator.”

It is to be hoped that the conditions imposed by DHS will improve patient conditions, and reduce deaths due to COVID-19, at this outer East Portland facility.

‘Infection control’ is a necessity
Many of the issues cited by DHS investigators, including issues about wearing face masks, gloves, and gowns, and the handling of soiled or contaminated surfaces or materials, falls under the category of “infection control”.

“This starts with education; in our facilities, we’d often hold brief, informal, ‘stand-ups’ or ‘huddles’ to supplement full in-service training classes, which are primary to make sure all staff members are alert and actively working on infection control, often held at the start of each shift at nursing stations, permitting the rapid dissemination of a critical of material,” the operator said.

In their facilities, a microbiologist did tests on a regular basis, and was on call as well. “Tracking nosocomial infections (in-house infections) determines a baseline, which points out causes for poor infection control before emergencies arise,” the operator stated. “Even with all of the confusing news about COVID-19 it is still a good idea to go into ‘top gear’ to begin to address the possibility of a new kind of infection, as soon as an operator learns of an impending pandemic.”

On April 18, DHS and Oregon Health Authority announced a multi-agency support team for long-term care facilities.

“Hopefully, this facility will be able to train, or retrain, their workers to reduce the spread of COVID-19 inside the facility – and, as important, reduce the risk of spreading the coronavirus to the workers’ families and community,” the microbiologist commented.

An official with Healthcare at Foster Creek told reporters that the company does intend to request a hearing to dispute the findings of the report.

UPDATE:
On May 5, the Oregon DHS issued an emergency suspension of Healthcare at Foster Creeks state license to operate a nursing facility and is seeking alternative care providers for its residents due to ongoing concerns about inadequate infection control to prevent the spread of COVID-19.

“We have worked on multiple strategies to contain the COVID-19 outbreak at Healthcare at Foster Creek and have concluded that moving all residents is mandatory at this stage,” said Mike McCormick, interim director of the DHS Office of Aging and People with Disabilities, which licenses long-term care facilities.

“Our hearts go out to everyone who has been impacted by COVID-19 at this facility and our focus now is on providing a smooth transition for residents and their families,” McCormick added.

© 2020 David F. Ashton ~ East Portland News™

 

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